Grading(down grading and upgrading), Slides of Occupational therapy

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GRADING

Activity Synthesis

• (^) Activity synthesis includes

adapting, grading, and reconfiguring

activities and is considered a

legitimate tool used in OT practice.

• (^) Adaptation refers to the process of

changing steps during an activity so

that the client is able to Manage in

it.

Cont’d

• (^) For example, in the case of a child who is fearful of movement and needs to improve or develop righting reactions, the practitioner may have him or her sit on a therapy ball to elicit righting reactions.

Cont’d

• (^) However, because of the child’s fear of movement, the practitioner might begin the intervention with a smaller ball that allows the feet to stay on the ground and provides slow, controlled movements. The practitioner can make the activity easier or more difficult to find the right challenge for the child.

Cont’d

• (^) The OT practitioner determines the type and extent of

grading based on clinical reasoning. A client’s level of

performance changes when he or she participates in

activities that are graded for his or her needs.

• (^) Once the practitioner has adapted and graded an

activity, it is presented in its “real” form, thus

synthesizing the analysis, adaptation, and grading into

the activity itself.

Cont’d

• (^) For example, finger feeding is acceptable

while a child is learning self-feeding.

• (^) The activity is then adapted by the

introduction of a utensil. It would be

acceptable initially for the child to hold the

utensil and attempt to use it to scoop or spear

food.

REFERENCES

1. Mackenzie L. Occupation Analysis in Practice.
2. AOTA. Occupational Therapy Practice Framework : Domain and Process Fourth Edition. Am J Occup Ther. 2020;74(2):1–87.